Yes
Contract Detail | AUM PHARMACEUTICALS INC | DBA AUM PHARMACY |
710 N EUCLID ST STE 103
| ANAHEIM | CA | 92801 | 04/14/2020 | 07/01/2020 | | 04/13/2023 | 04/13/2023 |
Contract Detail | TRAN-RX, LLC | DBA: ALLCARE PHARMACY #3 |
1106 E. 17TH ST STE B
| SANTA ANA | CA | 92701 | 04/13/2023 | 07/01/2023 | | | 07/01/2023 |
Details | Last Recertification Date | Update | Recertification | 1/31/2024 1:40:25 PM | 2/10/2025 5:23:01 PM | 2/10/2025 5:23 PM |
Details | Last Recertification Date | Update | Recertification | 1/30/2023 6:44:48 PM | 1/31/2024 1:40:25 PM | 1/31/2024 1:40 PM |
Contacts | Primary Contact | Update | PC Change Request | Duarte, Daisy
Clinic Operations Manager
North Orange County Regional Health Foundation
7144410111-8110 | Ramos, Lisa
Chief Operations Officer
North Orange County Regional Health Foundation
6572159696 | 2/9/2023 4:55 PM |
Details | Last Recertification Date | Update | Recertification | 2/28/2022 6:06:56 PM | 1/30/2023 6:44:48 PM | 1/30/2023 6:44 PM |
Contacts | Authorizing Official | Update | AO Change Request | triplett, andrew
CEO
North Orange County Regional Health Foundation
5097310263 | Magdaleno, Rocio
Chief Executive Officer
North Orange County Regional Health Foundation
7144410411-8106 | 9/14/2022 7:26 AM |
Contacts | Authorizing Official | Update | AO Change Request | Shelton Finch, Ramona
CEO
North Orange County Regional Health Foundation
7144410411 | triplett, andrew
CEO
North Orange County Regional Health Foundation
5097310263 | 2/28/2022 9:09 PM |
Details | Last Recertification Date | Update | Recertification | 2/8/2021 7:08:36 AM | 2/28/2022 6:06:56 PM | 2/28/2022 6:06 PM |
Addresses | Main Address | Update | Change Request |
901 W Orangethorpe Avenue
Fullerton, CA 92832 |
1182 N Euclid Street
Anaheim, CA 92801 | 11/23/2021 7:45 AM |
Details | Entity Subname | Update | Change Request | North Orange County Regional Health Foundation | Family Health Matters Community Health Center | 11/23/2021 7:45 AM |
Addresses | Billing Address | Insert | Change Request | | North Orange County Regional Health Foundation (Dba Family Health Matters)
1182 N Euclid Street
Anaheim, CA 92801 | 6/17/2021 3:51 PM |
Contacts | Primary Contact | Update | Change Request | Wu, Jane
PA
North Orange County Regional Health Foundation
7144410411 | Duarte, Daisy
Clinic Operations Manager
North Orange County Regional Health Foundation
7144410111-8110 | 6/17/2021 3:51 PM |
Addresses | Main Address | Update | Recertification |
901 West Orangethorpe Avenue
Fullerton, CA 92832 |
901 W Orangethorpe Avenue
Fullerton, CA 92832 | 2/8/2021 7:08 AM |
Medicaid Billing | NPI: State | Update | Recertification | | CA | 2/8/2021 7:08 AM |
Details | Last Recertification Date | Update | Recertification | 1/28/2020 5:27:28 PM | 2/8/2021 7:08:36 AM | 2/8/2021 7:08 AM |
Details | Last Recertification Date | Update | Recertification | | 1/28/2020 5:27:28 PM | 1/28/2020 5:27 PM |
Details | State | Update | | Approved | Active | 1/1/2020 12:04 AM |
Contacts | Signed By | Insert | New Registration | | Shelton Finch, Ramona
CEO
North Orange County Regional Health Foundation
7144410411 | 11/14/2019 2:37 PM |
Details | 340B ID | Update | New Registration | | CHC33647-00 | 11/14/2019 2:37 PM |
Dates | Participating Approval Date | Update | New Registration | | 11/14/2019 2:37:53 PM | 11/14/2019 2:37 PM |
Details | State | Update | New Registration | Pending | Approved | 11/14/2019 2:37 PM |
Dates | Signed By Date | Update | New Registration | | 11/13/2019 3:34:05 PM | 11/14/2019 2:37 PM |
Dates | Start Date | Update | New Registration | | 1/1/2020 12:00:00 AM | 11/14/2019 2:37 PM |
Addresses | Main Address | Insert | New Registration | |
901 West Orangethorpe Avenue
Fullerton, CA 92832 | 11/13/2019 3:34 PM |
Medicaid Billing | Medicaid: Is Primary | Insert | New Registration | | False | 11/13/2019 3:34 PM |
Medicaid Billing | Medicaid: Number | Insert | New Registration | | 1194974402 | 11/13/2019 3:34 PM |
Medicaid Billing | Medicaid: State | Insert | New Registration | | CA | 11/13/2019 3:34 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1194974402 | 11/13/2019 3:34 PM |
Contacts | Authorizing Official | Insert | New Registration | | Shelton Finch, Ramona
CEO
North Orange County Regional Health Foundation
7144410411 | 11/13/2019 3:34 PM |
Contacts | Primary Contact | Insert | New Registration | | Wu, Jane
PA
North Orange County Regional Health Foundation
7144410411 | 11/13/2019 3:34 PM |
Details | Last Recertification Date | Insert | New Registration | | | 11/13/2019 3:34 PM |
Details | Grant Number | Insert | New Registration | | H80CS33647 | 11/13/2019 3:34 PM |
Details | 340B ID | Insert | New Registration | | | 11/13/2019 3:34 PM |
Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 11/13/2019 3:34 PM |
Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 11/13/2019 3:34 PM |
Details | Medicare Provider Number | Insert | New Registration | | | 11/13/2019 3:34 PM |
Details | Entity Name | Insert | New Registration | | North Orange County Regional Health Foundation | 11/13/2019 3:34 PM |
Details | Program Code | Insert | New Registration | | CH | 11/13/2019 3:34 PM |
Details | Entity Subname | Insert | New Registration | | North Orange County Regional Health Foundation | 11/13/2019 3:34 PM |
Dates | Participating Approval Date | Insert | New Registration | | | 11/13/2019 3:34 PM |
Details | State | Insert | New Registration | | Pending | 11/13/2019 3:34 PM |
Dates | Registration Date | Insert | New Registration | | 11/13/2019 3:34:02 PM | 11/13/2019 3:34 PM |
Dates | Signed By Date | Insert | New Registration | | | 11/13/2019 3:34 PM |
Dates | Start Date | Insert | New Registration | | | 11/13/2019 3:34 PM |
Terminations | Termination Comments | Insert | New Registration | | | 11/13/2019 3:34 PM |
Terminations | Termination Date | Insert | New Registration | | | 11/13/2019 3:34 PM |
Terminations | Termination Effective Date | Insert | New Registration | | | 11/13/2019 3:34 PM |
Terminations | Termination Reason | Insert | New Registration | | | 11/13/2019 3:34 PM |